An enema is a procedure where liquid is introduced into the rectum and colon through the anus to treat various medical conditions. There are two main types of enemas - evacuant enemas which are intended to empty the bowels, and retention enemas which are meant to be retained. Common indications for enemas include constipation, digestive disorders, and diarrhea. Contraindications include bleeding piles, acute colon inflammation, and pregnancy. The procedure involves lying in a positioned and inserting an enema tube or catheter to allow liquid to flow into the rectum.

1. SEMEY MEDICAL UNIVERSITY
Topic- Enemas
SIW
SUBMITTED BY- HITESH KUMAR GODRA
GROUP- 249
SUBMITTED TO- NATALIYA MAM
SEMEY-2019
BASICS OF MEDICAL PRACTICE

2. PLAN
Introduction
Indications
Contraindications
Requirements
Procedure
Types
Evacuant enema
Retention enema
Reference

3. INTRODUCTION
• An enema is the procedure of introducing liquids into the rectum and
colon via the anus.
• Enemas is carried out as treatment for medical conditions in
Ayurveda as well as naturopathy.
Definition
“Enema is a method of treatment in which liquid is introduced into the rectum
and colon through the anus, then flushed out through the bowels”.

4. INDICATIONS
» Constipation
» Digestive disorder
» Diarrhea
» Obesity
» Warm infection

5. CONTRAINDICATIONS
» Bleeding piles
» Acute inflammation of colon
» Ulcer
» Pregnancy
» Rectum malignancy

6. REQUIREMENTS
» Standard enema tube
» Enema pot
» Rubber enema catheter
» Liquid

7. PROCEDURE
» Lie down on a hard bed
» Buttocks should be
higher then rest of the
body
» The enema bag with
water should be
suspended from a nail at
a height of 3feet from
the body

8. PROCEDURE
» The nozzle should be introduced in the rectum
» Open the stop cork & allow liquid to flow inside rectum
» Ask the patient to walk briskly for 10 minutes and then
evacuate

9. TYPES
1. Evacuant enemas are intended to be Returned.
2. Retention enemas are intended to be Retained.
Evacuant Retention
1. Warm water 1. Starch opium
2. Enema saponis 2. Normal saline
3. Glycerine 3. Astringent
4. Olive oil 4. Nutrient
5. Castor oil 5. Magnesium sulphate
6. Turpentine 6. Barium

10. Evacuant enemas
1. Enema Saponis- It is used to empty the lower bowel in constipation
and in preoperative preparations of patients.
2. Glycerine- 2-4 drachms of glycerine is mixed with equal volume of
water and given rectally. It acts by irritating the wall of the rctum.
3. Olive oil- 5-10 ft oz of olive oil warmed at 37⁰C is given to soften
the hard scybala.
4. Castor oil- 1-2 ft oz castor oil is well mixed with 2-4 fl oz of olive oil
and given slowly. It is used in severe constipation with impacted
feces.

11. Evacuant enemas
5. Turpentine- Oil of turpentine ½ fl oz is mixed with starch or soap
and water enema. There must be no floating globules. Petroleum
jelly should be smeared around the anus to prevent irritation. It is
useful in postoperative distension and in distension following
enteric fever.
Dangers
1. Ulceration of the rectum.
2. It may get absorbed and damage the kidneys.

12. Retention enemas
1. Starch opium enema- This is prepared by taking starch and making
a smooth paste with cold water to this opium is added and heated
to 37⁰C. It is injected by glass syringe or catheter rubber tubing and
syringe barrel. It is given for relief of pain or to treat excessive
diarrhea.
2. Normal saline enema- This is sometimes given to counteract shock
or dehydration. Patient can absorb up to 2-3L of fluids in 24 hr and
the danger of I.V. infusion is avoided.
3. Nutrient enema- Predigested food can be given rectally as rectum
can absorb fluids.

13. Retention enemas
4. Astringent enema- It is ordered in sydentary and ulcerative
conditions of rectum and colon. It is injected very gently and the
patient is encouraged to retain it as long as possible. The amount is
gradually up to 1-2 ½ L. The patient lies on the back with hips
raised.
5. Magnesium sulphate- Epson salts 1-2 oz is dissolved in 4-8 fl oz of
boiling water and cooled. It is used to reduce raised intracranial
pressure by osmotically drawing fluid into the gut. It should be
given slowly and retained as long as possible.

14. Retention enemas
6. Barium enema- It is an X-ray exam that can detect changes or
abnormalities in the large intestine (colon). The procedure is also
called a colon X-ray. In this enema technique a liquid that contains a
metallic substance (barium) is injected into rectum through small
tube. Barium coats the lining of the colon that results into a
relatively clear silhouette of the colon.

15. REFERANCE
 BOOKS
Practical Medicine – P.J.Mehta’s
Nursing Skills and Practice
INTERNET
www.mayoclinic.org/bariumenema
www.healthline.com/emema

16. Thankyou for your
Attention!